Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC-13956 | CA |
N | 111NX0100X | Occupational Health | QME 006232 | CA |
NPI | 1699711077 |
---|---|
Provider Name | Dr. Michael Nicholas Budincich |
First Address | Pasadena, CA 91106-1907 |
Second Address | Pasadena, CA 91106-1907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 08/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T17657 | (02) | CA |